Application of Local Vibrations in Delayed and Non-union Fractures: a Case Study. C. Trombetta Eng MA PhD 1,2 , P. Abundo Eng MA 1 , A. Civitella MD 3 , N. Rosato FP 1 and C. Foti MD FP 3. 1 Medical Engineering Service, Fondazione Policlinico Tor Vergata, Rome - PowerPoint PPT Presentation
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Application of Local Vibrations Application of Local Vibrations in Delayed and Non-union in Delayed and Non-union Fractures: a Case Study Fractures: a Case Study C. Trombetta Eng MA PhD 1,2 , P. Abundo Eng MA 1 , A. Civitella MD 3 , N. Rosato FP 1 and C. Foti MD FP 3 1 Medical Engineering Service, Fondazione Policlinico Tor Vergata, Rome Medical Engineering Service, Fondazione Policlinico Tor Vergata, Rome 2 PhD student in Advanced Technology in Rehabilitation Medicine, Tor Vergata University, Rome PhD student in Advanced Technology in Rehabilitation Medicine, Tor Vergata University, Rome 3 Tor Vergata University, Physical and Rehabilitation Medicine, Public Health Department, Rome Tor Vergata University, Physical and Rehabilitation Medicine, Public Health Department, Rome
Transcript
Application of Local Vibrations in Delayed Application of Local Vibrations in Delayed
and Non-union Fractures: a Case Studyand Non-union Fractures: a Case Study
C. Trombetta Eng MA PhD1,2, P. Abundo Eng MA1, A. Civitella MD3,
N. Rosato FP1 and C. Foti MD FP3
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Medical Engineering Service, Fondazione Policlinico Tor Vergata, RomeMedical Engineering Service, Fondazione Policlinico Tor Vergata, Rome22
PhD student in Advanced Technology in Rehabilitation Medicine, Tor Vergata University, RomePhD student in Advanced Technology in Rehabilitation Medicine, Tor Vergata University, Rome33
Tor Vergata University, Physical and Rehabilitation Medicine, Public Health Department, RomeTor Vergata University, Physical and Rehabilitation Medicine, Public Health Department, Rome
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Aim:
Assess efficacy of Local Vibrations (LV) in delayed-union
and non-union fractures through therapeutic vibration
exercise by analysing radiographic appereance
Local Vibrations and Bone Regeneration: Local Vibrations and Bone Regeneration:
Case StudyCase Study
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Mechanical Factors vs Body Response
improve muscular functions
increase bone regeneration
process by stimulating the muscle
increase remineralization activity
by triggering osteoblasts
Mechanical factors hold an important role in human body
adaptive response, as vibrations:
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Vibration Exercise
Whole Body Vibrations (WBV)
Upper Arm Vibrations (UAV)
Local Vibrations (LV)
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
to strengthen the muscle after
peripheral nervous system lesions
or myo-osteo-articular lesions to reinforce muscle and minimize
muscle hypotrophy after
orthopedic surgery
Why Local Vibrations??
Clinical necessity: focus effects of treatment
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
to improve muscle distensibility in
joint recovery, in posture changes
caused by retraction myo-tendon
and in muscle lesions to amplify the proprioceptive
afferents in balance alterations and
proprioceptive recovery after
orthopedic lesions
Why Local Vibrations??
Clinical necessity: focus effects of treatment
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Why Local Vibrations??
Clinical necessity: focus effects of treatment on specific body segments
Solution: LV
Body is a system with n-degrees of freedom, every segment has its own resonance frequency
Vibration effects depend on frequency, time and level of exposure
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Design of a Specific Device
Device dedicated to LV application for bone regeneration and muscle strength
allow the operator to increase the strain applied on the subject in relation to different applications
comparable geometry with limb
protect the operator from vibratory stress
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Design of a Specific Device
Device dedicated to LV application for bone regeneration and muscle strength
Medical Engineering and Rehabilitation Medicine Department at the Tor Vergata University Medical Engineering and Rehabilitation Medicine Department at the Tor Vergata University
in collaboration with the company Boscosystemlabin collaboration with the company Boscosystemlab
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Non-union and Delayed-union Fractures
Failure of a fractured bone to heal normally
Non-union: cessation of all reparative processes of healing without bone union
Delayed-union: prolongation of time to fracture union
Young Researchers Meeting Rome Rome, 9th February 2010
Vibration Energy in Orthopaedic Disabilities Vibration Energy in Orthopaedic Disabilities
Non-union and Delayed-union Fractures
Differentiation between delayed union and non union is often based on radiographic criteria and time
Failure to show any progressive change in the radiographic appearance is evidence of non-union
The changes in radiographic appearance may be slight
radiographs should be scrutinized monthly
Case StudyCase Study
Young Researchers Meeting Rome Rome, 9th February 2010
Characteristicsage 51
sex male
weight 108 kg
height 185 cm
Male patient presenting right tibia fracture
Anamnesis
2004 Right tibia decomposed fragmented fracture which demanded reduction and fixation with plates and screws and metal cerclage
2008 Right leg TC showed redundant callus with no consolidation and reduced bone density: non-union fracture diagnosis
Case StudyCase Study
Young Researchers Meeting Rome Rome, 9th February 2010
Monthly program was scheduled consisting in:
daily treatments of 6 series
of 5 repetitions at 35Hz
30’’ time application for
each repetition
1’ pause between repetitions
1’ 30’’ pause between series
Application on the heel
Case StudyCase Study
Young Researchers Meeting Rome Rome, 9th February 2010
Since the early applications:
a reduction of perilesion edema was shown
the algic symptomatology improved
improvements in paresthetic symptomatology
Case StudyCase Study
Young Researchers Meeting Rome Rome, 9th February 2010
